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11.27.2010

The Rage of Achilles and PTSD in Antiquity

Then said Achilles, "Son of Atreus, king of men Agamemnon, see to these matters at some other season, when there is breathing time and when I am calmer. Would you have men eat while the bodies of those whom Hector son of Priam slew are still lying mangled upon the plain? Let the sons of the Achaeans, say I, fight fasting and without food, till we have avenged them; afterwards at the going down of the sun let them eat their fill. As for me, Patroclus is lying dead in my tent, all hacked and hewn, with his feet to the door, and his comrades are mourning round him. Therefore I can think of nothing but slaughter and blood and the rattle in the throat of the dying."

The Iliad might have been better named the Wrath of Achilles, because that's the theme of the book. His rage after the death of his friend Patroclus is often described as a classic sign of PTSD. Achilles features in Jonathan Shay's Achilles in Vietnam: Combat Trauma and the Undoing of Character which is one of the classic studies of PTSD, although I have no read it. Wrath and anger are signs associated with PTSD, and every time some man goes on a rampage and shoots people, then PTSD seems to get brought up. Shay wrote a follow-up on Odyssey, and those sorts of wanderings - ten years to get home?!? - seem closer to the mind-set of the vets I was in Group with that ended up homeless. (An NPR interview with Shay can be found here).

A lot of people are reluctant to discuss their PTSD publicly, because they don't want to be tared with this association. I didn't do the anger / killing spree / Rambo style massacres, and nor did the many others I know who were treated for PTSD. In some ways the term used in World War I - 'shell shock' - is more appropriate; people go into shock rather than exhibiting anger or rage. I've already covered why I came 'out' - I would rather do so than be blackmailed - and I was worried initially that people would fear I'd turn around and stab them with a kitchen knife or something, but luckily anyone who spend more than two minutes with me quickly works out that that's not the case.

I'm writing a book on ancient women who led armies, and although I've only written a quarter or so, I've done all the research, and it surprises me that there are so few mentions in Greek or Roman sources of peoples' reactions to battles. Mostly war was glorified.

There are a few ancient accounts however that do fit in with the 'shell shock' type of PTSD. Herodotus mentions a soldier at Marathon who lost his sight during the battle:

A strange prodigy likewise happened at this fight. Epizelus, the son of Cuphagoras, an Athenian, was in the thick of the fray, and behaving himself as a brave man should, when suddenly he was stricken with blindness, without blow of sword or dart; and this blindness continued thenceforth during the whole of his after life. The following is the account which he himself, as I have heard, gave of the matter: he said that a gigantic warrior, with a huge beard, which shaded all his shield, stood over against him; but the ghostly semblance passed him by, and slew the man at his side. Such, as I understand, was the tale which Epizelus told.

I can be a bit OCD, and like to point out that only 298 Spartans died at Thermopylae. In this context it's also worth pointing out that Leonidas also gave his allied men a 'mental health' break at the battle, realising that they were emotionally exhausted from previous fighting, and wouldn't be of much use, he ordered them to retreat:

It is said that Leonidas himself sent away the troops who departed, because he tendered their safety, but thought it unseemly that either he or his Spartans should quit the post which they had been especially sent to guard. For my own part, I incline to think that Leonidas gave the order, because he perceived the allies to be out of heart and unwilling to encounter the danger to which his own mind was made up. He therefore commanded them to retreat, but said that he himself could not draw back with honour; knowing that, if he stayed, glory awaited him, and that Sparta in that case would not lose her prosperity.

The shell shock type of PTSD made soldiers incapable of fighting further, but others were functional as warriors and warred on. A big part of PTSD is the flash-backs and nightmares, which in turn prevent people from sleeping, so the first course of treatment tends to be tranquilisers or sleeping pills so that patients can get the rest they need.

The suicide of Ajax is interesting as a phenomenon, because although in Judeo-Christian society suicides tend to be hushed-up, his was told in literature, and depicted in art. I suspect that this is because, in an era when most citizens took part in military life, that many men could relate to his story which reads like a textbook case of rage PTSD. Ajax the mighty warrior took out his anger on a flock of sheep, in a delusion thinking they were the enemy, then took his own life.

Robin Lane Fox, Oxford academic and biographer of Alexander the Great, wrote in a column on Gardening Therapy for PTSD "Ignorantly, I used not to believe in PTSD. I thought that veterans should get out into the fresh air and stop whingeing" (FT) ... I have to admit, that the 'pull your socks up and get on with it' form of therapy was the one I chose for a long time. It doesn't work. But Prof Lane Fox should have been aware of this description of PTSD from Plutarch's Life of Alexander:

All which made such a deep impression of terror in Cassander's mind that, long after, when he was King of Macedonia and master of Greece, as he was walking up and down at Delphi, and looking at the statues, at the sight of that of Alexander he was suddenly struck with alarm, and shook all over, his eyes rolled, his head grew dizzy, and it was long before he recovered himself.

If that's not an anxiety attack, then I'm not sure what is. There have also been studies that see Alexander the Great as having suffered from PTSD (see here). I've seen people de-bunk these on the grounds that he couldn't have led an army whilst suffering from PTSD, but ... I've seen plenty of soldiers do so, and it is possible to function whilst suffering from PTSD amazingly well (people tend to use disassociation and use throwing themselves into work as a way of avoiding dealing with the issues)

When I was researching Gaius Marius (someone recently published a book on him, so that one is alas on the back-burner), like many other historians I had a huge problem with him - for most of his life he was this great man, a brilliant soldier, a leading political reformer, then at the end he goes a bit mad and has a lot of enemies killed. I've read countless theories about what made him 'flip' in this way, but the only one that makes sense to me is that he was deeply traumatised by having to flee Rome into exile and being hunted down by Sulla's men as an enemy of Rome. The vacillation about wanting to enter the city he had re-captured but waiting to be invited into Rome officially, make sense to me. I can't relate to the rage of killing people, but this is a textbook symptom of rage PTSD. Even Plutarch mentions Marius' anxieties on his death-bed, including the irrational fear of Sulla marching on Rome - since Sulla was stuck in Greece fighting Mithridates (Life of Marius):

45.2 But Marius himself, now worn out with toils, deluged, as it were, with anxieties, and wearied, could not sustain his spirits, which shook within him as he again faced the overpowering thought of a new war, of fresh struggles, of terrors known by experience to be dreadful, and of utter weariness. He reflected, too, that it was not Octavius or Merula in command of a promiscuous throng and a seditious rabble against whom he was now to run the hazard of war, but that the famous Sulla was coming against him, the man who had once ejected him from the country, and had now shut Mithridates up to the shores of the Euxine Sea.

3Tortured by such reflections, and bringing into review his long wandering, his flights, and his perils, as he was driven over land and sea, he fell into a state of dreadful despair, and was a prey to nightly terrors and harassing dreams, wherein he would ever seem to hear a voice saying:—

"Dreadful, indeed, is the lions' lair, even though it be empty."

And since above all things he dreaded the sleepless nights, he gave himself up to drinking-bouts and drunkenness at unseasonable hours and in a manner unsuited to his years, trying thus to induce sleep as a way of escape from his anxious thoughts.

4 And finally, when one came with tidings from the sea, fresh terrors fell upon him, partly because he feared the future, and partly because he was wearied to satiety by the present, so that it needed only a slight impulse to throw him into a pleurisy, as Poseidonius the philosopher relates, who says that he went in personally and conversed with Marius on the subjects of his embassy after Marius had fallen ill.

5 But a certain Caius Piso, an historian, relates that Marius, while walking about with his friends after supper, fell to talking about the events of his life, beginning with his earliest days, and after recounting his frequent reversals of fortune, from good to bad and from bad to good, said that it was not the part of a man of sense to trust himself to Fortune any longer; and after this utterance bade his friends farewell, kept his bed for seven days consecutively, and so died.

6 Some, however, say that his ambitious nature was completely revealed during his illness by his being swept into a strange delusion. He thought that he had the command in the Mithridatic war, and then, just as he used to do in his actual struggles, he would indulge in all sorts of attitudes and gestures, accompanying them with shrill cries and frequent calls to battle.

7 So fierce and inexorable was the passion for directing that war which had been instilled into him by his envy and lust of power. And therefore, though he had lived to be seventy years old, and was the first man to be elected consul for the seventh time, and was possessed of a house and wealth which would have sufficed for many kingdoms at once, he lamented his fortune, in that he was dying before he had satisfied and completed his desires.

The mention of drinking to drive away the nightmares and the lack of sleep are classic signs of PTSD. Unfortunately too many people self-medicate with alcohol and drugs, because the underlying mental health issues are undiagnosed - and that's why too many veterans end up homeless, living on the streets. I'm amazed nobody else has suggested that Gaius Marius was suffering from Post-Traumatic Stress Disorder.

I've covered examples of PTSD suffered by soldiers in this post, because these are the ones we have in the sources. The victims of war tend to get ignored by history, but those that were tortured, enslaved or rape by the soldiers probably suffered from PTSD too. My only advice is that if you think you're having issues, then ask for help and talk to a doctor. Ignoring them won't make them go away.

9 comments:

Excellent essay -- I think you make several insightful points backed by solid textural research.

It is interesting to note that writing has often served as a therapy for the traumas of combat.

After the First World War, several veterans of the trenches put their experiences into print, including the classicist Robert Graves and the Oxford Don J.R.R. Tolkien. Many have thought The Lord Of The Rings a commentary on World War Two, but in fact it has more to do with what Tolkien saw in the trenches.

WWII produced even more literature, including much written by the civilians caught up in the conflict (The Theory And Practice of Hell, This Way For Gas Ladies And Gentlemen, Night, The Painted Bird, etc.).

However, the books by soldiers continue to be the most searing. The Warriors by J. Glenn Gray remains the benchmark work against which others are measured, and others have measured up. Doing Battle by Paul Fussell, The Forgotten Soldier by Guy Sajer, In Pharaoh's Army by Tobais Wolff and of course, one of the very best, Slaughterhouse Five by Kurt Vonnegut.

If Achilles had lived would he have sought solace in writing, and if so what would he have written?

I'm currently reading Caesar: Life of a Colossus and I think Caesar may have had PTSD. Many soldiers who suffer from PTSD have difficulty with adjusting to civilian life. So did Caesar. From his mid-teens on, Caesar was always on guard against his enemies. The pirates who kidnapped him on his way to Rhodes, being chased out of Rome by Sulla,fighting off rebelling Gaulic tribes, seeing his old friend and competetor Pompey's cut off head, etc. Although he had several opportunities to stay put in Rome with a strong political and power base behind him, he never seemed to be able to re-adapt to civilian life. Even up to his last days he was planning another military offensive against the Parthians. Some of the worst sufferers of PTSD in the modern military are the ones who also re-enlist the most.

no longer referred to as "shell-shock", it is, none the less, more common than ever. ptsd as a condition does not require a formal military context. all too often, gruesome reportings reveal seemingly "normal" people suddenly going "berserk"; hacking and even eating family and strangers alike in moments of self-destructive madness, usually traced back to a violent and excessively stressful childhood.

Though PTSD does not often manifest itself in violent actions, the manifestation of violence may be caused by the existence of PTSD. I agree that PTSD does not mean someone is going to blow-up with the right set of circumstances in place. My gut, from anecdotal observation, is that PTSD is a mental response to extreme stress and the inability to control a very distressing situation. Death and maiming of comrades, family, or self.

One worry I have is that if PTSD is ascribed too often, then other important factors contributing to abnormal behavior begin to be lost in the analysis of the subject or patient.

"My gut, from anecdotal observation, is that PTSD is a mental response to extreme stress and the inability to control a very distressing situation. Death and maiming of comrades, family, or self." That seems right to me.

I think like a lot of 'new' conditions a lot of not really qualified people tend to throw the label around - for example also 'psychopath' - not realising the correct medical implications.

There has been interesting research suggesting that both PTSD and psychopathy can be seem on MRI scans. (I have mine of disc somewhere, though frankly would have no idea what to look for).

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